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目的研究戊酸雌二醇(长效雌激素)在绝经后肾功能衰竭(ESRD)腹膜透析患者体内的代谢特征。方法6位ESRD并接受腹膜透析绝经后妇女为受试者(试验组),6位绝经后健康妇女作为对照(对照组),均单次口服戊酸雌二醇1mg,抽血,均留取尿液标本;试验组还留取腹膜透析液,检测雌二醇(E2)含量;并在用药前和用药72h测定2组血中血清白蛋白、性激素结合球蛋白(SABG)及黄体生成素、卵泡刺激素、雄激素、孕激素、泌乳酸(PRL)浓度。结果用药前后,试验组总E2清除率、血白蛋白及SABG明显低于对照组;而血中游离E2浓度明显高于对照组。用药前后,2组内及组间各指标无明显差异;但实验组PRL水平高于对照组。结论ESRD腹透患者口服E2在体内有蓄积,因此其口服剂量应较正常人减量;若长期用药,推荐减半剂量。
Objective To investigate the metabolic characteristics of estradiol valerate (long-acting estrogen) in peritoneal dialysis patients with postmenopausal renal failure (ESRD). Methods Six postmenopausal women undergoing peritoneal dialysis were enrolled in this study. Six postmenopausal women were enrolled in this study. Six postmenopausal women received a single oral administration of 1 mg estradiol valerate, The urine samples were also collected from the peritoneal dialysis fluid in the experimental group. The levels of estradiol (E2) in the peritoneal dialysis fluid were also measured. Serum albumin, sex hormone-binding globulin (SABG) and luteinizing hormone were measured before treatment and 72h after treatment. Follicle stimulating hormone, androgen, progestin, lactate (PRL) concentration. Results Before and after treatment, the total E2 clearance, serum albumin and SABG in the experimental group were significantly lower than those in the control group; however, the concentration of free E2 in the blood was significantly higher than that in the control group. Before and after treatment, there was no significant difference between the two groups and between groups; however, the PRL level in the experimental group was higher than that in the control group. Conclusion ESRD peritoneal dialysis patients with oral E2 accumulation in the body, so the oral dose should be less than normal; if long-term medication, it is recommended to halve the dose.